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Inspection on 09/08/05 for Pinehurst Residential Care Home, Ilfracombe

Also see our care home review for Pinehurst Residential Care Home, Ilfracombe for more information

This inspection was carried out on 9th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This inspection showed that good residents records and assessments are in place at Pinehurst, this helps to ensure that appropriate care is given and that important information is available to staff. The residents at Pinehurst are treated with courtesy and respect and importance is placed on residents` privacy and dignity, residents at Pinehurst particularly highlighted the care staff and the care they receive from them as being very good and this helps them to feel secure and confidant that they will be well cared for. Residents explained that Pinehurst has a good reputation and that this together with visiting the home for themselves (or family visiting on their behalf) helped them decided to choose Pinehurst as their long-term home. The manager has good working relationships with care staff within the home and local health care staff. Local health care services are involved in residents care as are needed and equipment to assist residents is also provided, this prevents residents developing health problems and assists in treating residents who have or do develop health problems. This gives residents, relatives and staff confidence that residents` health needs are well managed and understood by the manager and staff. The residents are well cared for by staff that are willing and supported to go on training courses. Training helps to make sure that the care staff at Pinehurst have the up to date skills and knowledge they need to give a good level of care to residents. Pinehurst provides a homely, caring and open environment for residents, visitors and staff.

What has improved since the last inspection?

Since the last inspection, improvements to the environment have been made which include; redecoration of the hallway, the refurbishment of a resident`s room, the provision of a new medicine storage facility and a new medication fridge. New assessments have also been introduced, one is based on good practice guidelines from the dementia forum and a falls and osteoporosis risk assessment as promoted by the falls co- coordinator is now used. Staffing levels have increased which enables staff to spend more time with residents.

What the care home could do better:

Window restictors are not in place to upper floor windows which means that risk of falling from widow openings remains a possibility. Risk assessments, which are subject to regular review, are needed for all residents in relation to all unrestricted window openings. Any potential risk should be removed.

CARE HOMES FOR OLDER PEOPLE Pinehurst Residential Care Home Pinehurst 14 Chambercombe Park Road Ilfracombe Devon, EX34 9QN Lead Inspector Adele Adams Announced 9th August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Pinehurst Residential Care Home Address Pinehurst, 14 Chambercombe Park Road, Ilfracombe, Devon, EX34 9QN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01271 862839 martinparmiter@hotmail.com Pinehurst Care Home Ltd Mrs Theresa Campbell Hutchinson Care Home 23 Category(ies) of Old age - not falling within any other category registration, with number (23), Dementia - over 65 years of age (23) of places Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is to be registered to accommodate 23 service users in the categories op old age and de [e] dementia over 65. Date of last inspection 15th March 2005 Brief Description of the Service: Pinehurst is a large, detached Victorian house with large grounds and a spacious decked balcony area complete with flowers and garden furniture, having pleasant views across the North Devon coastline.The home is on four levels; a stair lift provides access to each of the floors.There is a choice of three lounges one of which is a conservatory; each has a welcoming and individual feel to them. One lounge is adjacent to the dining room, which is situated off the reception hall, and there is also another dining room on the lower floor.The home has 17 single rooms and 3 double rooms, these are homely, and are personalised with residents’ personal possessions, each room has en-suite toilet facilities. The home is registered to meet the needs of service users aged over 65 and those with a dementia type illness.The home has a very experienced and respected manager and is recently under new ownership, the new owner has already commenced an improvement programme at the home. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection has introduced “Key Standards “ to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that all reports written within an inspection year (1st April to 31st March) be taken into consideration. This inspection was announced and took place between 10:00 and 15:10. During the inspection, the inspector spent time speaking with residents, relatives, the manager of the home, the homeowner and care staff. The inspector toured the home and was invited into the rooms of four residents. The inspector spent time in the lounge chatting to residents and observed residents and staff. Time was also spent time reading documentation, which included, resident records. What the service does well: This inspection showed that good residents records and assessments are in place at Pinehurst, this helps to ensure that appropriate care is given and that important information is available to staff. The residents at Pinehurst are treated with courtesy and respect and importance is placed on residents’ privacy and dignity, residents at Pinehurst particularly highlighted the care staff and the care they receive from them as being very good and this helps them to feel secure and confidant that they will be well cared for. Residents explained that Pinehurst has a good reputation and that this together with visiting the home for themselves (or family visiting on their behalf) helped them decided to choose Pinehurst as their long-term home. The manager has good working relationships with care staff within the home and local health care staff. Local health care services are involved in residents care as are needed and equipment to assist residents is also provided, this prevents residents developing health problems and assists in treating residents who have or do develop health problems. This gives residents, relatives and staff confidence that residents’ health needs are well managed and understood by the manager and staff. The residents are well cared for by staff that are willing and supported to go on training courses. Training helps to make sure that the care staff at Pinehurst have the up to date skills and knowledge they need to give a good level of care Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 6 to residents. Pinehurst provides a homely, caring and open environment for residents, visitors and staff. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 and 5 Each resident or their family or carer are provided with enough information, when they enquire about vacancies at the home, to help enable them to make a decision. Residents and their families can be confident that they are fully informed about the home and are given every opportunity to view the home prior to admission. EVIDENCE: The inspector read three residents contracts with the home, which had been signed and dated; these each specify what is required by the standard. The inspector read two resident records, each contained both the manager’s assessment of the prospective resident’s needs and supporting social services assessments of care needs. Each resident has an assessment before moving into the home to ensure his or her needs can be adequately met and on moving to the home each resident signs a contract with the home. Residents and family are able to spend time at the home before making a final decision to move there, this helps with deciding whether or not the home is right for them and helps new residents and family to feel more familiar with the home and staff when they move there. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 9 The inspector spoke with relatives who confirmed they together with their relative had come to view the home to see if was suitable, another resident advised that their family had chosen the home on their behalf and another resident confirmed they had viewed the home before moving there, all confirmed that this had given them confidence when deciding on their choice of home. The inspector read the Statement of Purpose and was advised by relatives that they were sent information about the home on their enquiry about a vacancy. The manager advised there have been no amendments to the Statement of Purpose. Three residents told the inspector they are confidant with the care they receive at the home and relatives said they feel they now know that their relatives are well cared for and have confidence in the ability of staff at the home. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Residents receive care which has been appropriately planned and reviewed, which identifies their health and social care needs and states how these needs are met. Safe systems are in place in relation to medicine administration and residents feel supported by care staff with their medication needs. Each resident’s need for privacy, dignity and respect is recognised and respected by staff at Pinehurst. EVIDENCE: The inspector read two resident’s care records and daily records, which clearly show residents have access to healthcare and healthcare professionals and that visits to the home from healthcare professionals such as doctors and chiropodists take place. The residents spoken with during the inspection confirm they are registered with a doctor of their choice and one resident explained how important this was for them. Relatives described a health issue experienced by their relative who is resident in the home and how it was managed by the home and the family find this reassuring and have seen an improvement in their relative’s health. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 11 The inspector observed staff working and speaking with residents and noted although they know residents well, staff are courteous, professional and considerate in their approach and interactions with residents. Residents when speaking with the inspector confirmed that they are always referred to by their preferred term of address and that staff are considerate regarding residents’ privacy and dignity when carrying out personal care. Improvements in relation to the storage of medicines have been made following the previous inspection, a new ventilated storage cupboard and dedicated medication fridge has been provided and is in use, the temperature of the cupboard and fridge are monitored daily. The medication policy will be inspected at the unannounced inspection. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 14. Residents exercise choice and control over their lives and are able to maintain contact with family, friends and the local community. The activities provided for residents at Pinehurst have improved. EVIDENCE: The inspector read 2 residents care records, which gave an account of each residents life, including their social and relationship needs. The inspector noted that one contained specific detail about visitors – demonstrating that the staff at the home do enable residents to have control and choice. Four residents spoken with gave the inspector examples of the type of decisions they make about their lives, for example, one resident chose not to go on an outing that was hosted by the home, another chooses to eat meals alone, where others told the inspector they prefer to chose to eat in the company of other residents. Residents are able to choose whether or not they would like a private telephone in their room, two of the residents who have chosen to have telephone described it as ‘their lifeline’ as they use it to talk to their families and friends. There are more activities for residents at the home, the inspector was told of a recent outing by 2 residents and relatives, one resident particularly enjoyed eating an ice cream and looking at the sea and the swimmers. Photographs of the outing were on display in the hallway. A range of activities now include, nails and hair, musical exercises, a sing a long, reminiscence therapy and the Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 13 home have a contract with the county library who change books on a six weekly basis – they can also provide large print books and audio tapes. The residents spoken to during the inspection are aware of the activities and chose what they wish to participate in, one resident made a point of telling the inspector how much they enjoy having their hair done by the visiting hairdresser. Visitors are welcome at the home, two relatives told the inspector how welcome they feel and that if notice of their visit is given then a meal can be arranged for them, they were also impressed with the thought that goes into planning events for residents such as the Christmas ‘do’ and outings. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x To be inspected at the unannounced inspection. EVIDENCE: Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20,21,24 Pinehurst is homely, clean and maintained regularly, providing residents with a pleasant environment to live in, however, service users could be at risk as window restrictirs have not been fitted. EVIDENCE: The inspector toured the home and spoke with residents and relatives about the accommodation and facilities at Pinehurst. Four residents allowed the inspector to spend time with them in their rooms. The home has good access outside and inside a stair lift provides access to each floor. Parking spaces are situated at the front of the home. The home has three lounge areas for residents to choose from, on the day of inspection, residents were using the conservatory and upper lounge. Outside, there is a decked area with seating, tables and parasols with views out to sea available to residents. The home has a light and spacious feel to it with many of the rooms have high ceilings. Lighting is domestic in character and the range of seating is of a good quality. An alarm is accessible and available in every room. One resident with limited mobility was observed as having the alarm close at hand during the inspection. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 16 The alarms sounded during the inspection were observed as being promptly answered. Equipment is stored neatly and is unobtrusive but storage space is problematic due to the age and style of the home. The inspector saw that equipment is provided for residents, this included walking equipment and a pressure mattress. Four residents told the inspector they were very happy with their rooms and the residents’ rooms seen by the inspector were personalised. A maintenance person is employed at the home to undertake routine repairs. The manager showed the inspector a recently vacated room that has been refurbished before it is occupied. Window opening is not restricted, the necessity of this was discussed with the manager and owner. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 Residents are cared for by an appropriate number of competent staff that are supported to and do access training. EVIDENCE: The inspector spoke with 2 members of care staff who confirmed the training they have attended, the inspector saw evidence of staff attendance on training courses in the form of certificates, the manager confirmed that staff are able to undertake NVQ awards and the deputy manager advised the inspector she is to start the Registered Manager s award and NVQ Level 4 in September 2005 and is to attend college one day each week for this. The three residents asked about staffing numbers all told the inspector that their care is not rushed and they do not have to wait for call bells to be answered. A member of care staff told the inspector that an increase in staffing has enabled more time to be spent caring for residents, which is greatly appreciated. The manager advised that staffing levels at the home have been increased at peak times such as mornings and evenings, the staff rota was provided and also confirmed this. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 36 The manager runs Pinehurst effectively putting residents needs first. There is an open inclusive atmosphere from which all benefit. Residents and staff at Pinehurst benefit from staff receiving regular supervision. EVIDENCE: The inspector spoke with 6 residents, 2 members of staff, spent time with the manager, deputy manager and owner, read the staff supervision records and observed residents, relatives and staff at the home. This enabled the inspector to determine that staff now receive regular supervision which is being managed and recorded by the deputy manager, this has been taking place as group supervision and has had a practice development focus for staff – the deputy manager and manager confirmed that this is to be further developed with introducing individual one to one supervision as well. The manager of the home remains the same, observation of staff and residents and discussion with residents, staff and the manager and deputy manager and reading of documentation in the home all demonstrated that the home continues to be Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 19 well managed and that there is an open approach which residents and staff find beneficial. One of the residents told the inspector that the fact the home is’ smooth running is a big plus and is one of the best things about the home for them’. Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 3 3 x x 3 x x STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x x x 3 x x Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 38 Regulation Requirement Timescale for action 31.10.05 13(4)(a)(c Regularly reviewed risk ) assessments must be held for each resident to show if they are at risk from any unrestricted window openings on the upper floors of the home and action must be taken to remove risk. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon, TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Pinehurst Residential Care Home D54-D07 S62484 Pinehurst Residential Care Home V234519 090805 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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